Pike, Brigid
(2012)
Funding drugs services in a recession.
Drugnet Ireland,
Issue 41, Spring 2012,
pp. 12-13.
Budget 2012 outlines cuts to directly drug-related funding under two Votes – Education and Health (see table below).1 Current funding for education-related projects will drop by €132,000 (24%), while funding for pilot projects in drugs task force areas across the country, funded under the Drugs Initiative, will decrease by just over €2.5 million (7%). Against the trend, capital funding under the Drugs Initiative will increase by 38%.
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In 2010, in anticipation of a decline in its funding, one regional drugs task force commissioned an independent study to evaluate the efficiency and effectiveness of the 30 projects it had funded in 2008 and 2009, to undertake a needs assessment with regard to substance misuse in the region, to score the capacity of the evaluated projects to meet these needs, and to prepare a roadmap to ensure it continued to use its resources in the most effective way possible.2 Using the Rapid Assessment Response (RAR) method promoted by the World Health Organization (WHO) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the researchers who undertook the three-month study concluded that it is a useful approach for service planners and policy makers ‘who often have difficult funding decisions to make in short time frames and under competing pressures’. 3
A mix of quantitative and qualitative methods was used to gather data relevant to both the needs assessment and the performance evaluation:
· analysis of existing data sources on the prevalence and nature of the drug problem, to inform a retrospective needs analysis;
· the administration of a standardised needs assessment questionnaire to each service, to provide the basis for a prospective needs analysis;
· one-to-one qualitative interviews with service providers;
· consultations with regional stakeholders; and
· analysis of data collected relevant to service efficiencies, and of each service’s financial and monitoring data for the previous year.
The roadmap was developed in round-table discussions by the three researchers, based on triangulation and constant comparing of all the data gathered in the course of the study. This ensured that any inconsistencies in the data could be identified, and that the most relevant and efficient projects for the region emerged.
The main recommendations of the roadmap were as follows:
Strategic priorities: A short regional drugs strategic plan should be developed, adapting and localising the national drugs strategy by prioritising the national pillars of the strategy in line with the region’s needs and by setting clear measurable targets and outcomes for each pillar. The researchers proposed placing the pillars in the following order of local priority: (1) Treatment, (2) Rehabilitation and (3) Prevention.
Treatment:The roadmap proposed three targets – a drug substitution service for opiate users that ensured access to 100% of opiate users, comparability of local service provision to Dublin’s range of services, and availability of mental health services to substance misusers within one month of referral.
Rehabilitation: The researchers recommended that the region should engage closely with the National Drug Rehabilitation Implementation Committee (NDRIC) on how to localise its recommendations, and in preparation for shared care planning, it should implement a unique identifier system for clients in the region.
Prevention: Although the region had prioritised prevention among projects funded, the RAR revealed that work methods and approaches to the delivery of preventative education were uneven. The researchers suggested that the task force and regional service providers should examine the quality standards framework developed by the National Drug Education Workers Forum (DEWF). They also suggested that resources should be focused on those most ‘at risk’ , and to this end, ‘targeted’ and ‘selected’ interventions should be prioritised while other ‘more generic’ approaches could be delivered by organisations working with the regional population as a whole.
Funding: Table 5 in the published report shows how funding allocations could be made in accordance with the local strategic priorities; thus, funding to projects aligned with the top priorities should continue to be funded, funding to other projects should continue but their relevance or efficiency be further reviewed; and funding to other projects should be suspended, because the project is not of sufficient strategic importance or relevance, or the need could be met by some other means.
With regard to research, the roadmap recommended that the task force should form ‘a strategic alliance with an educational institute in the region in order to assist the development of the research pillar for the region’. In response to needs identified by services in relation to processes and support for projects (including the need for enhanced information sharing, the development of common working methods and the provision of training), the roadmap recommended a review of data collection methods and the appointment of a half-time monitoring and evaluation position for the region. (Brigid Pike)
1. Department of Finance (2011)
Comprehensive Expenditure Report 2012–2014. Part IV: Estimates for Public Services 2012 and Summary Public Capital Programme. Downloaded on 15 December 2011 from
http://budget.gov.ie/Budgets/2012/2012.aspx 2. Comiskey C, O’Sullivan K and Milnes J (2011) Regional drug user services in times of scarce financial resources: using a rapid assessment response approach to evaluate, plan and prioritize essential services. Substance Use & Misuse, 47 (3): 254–264.
3. The International Journal of Drug Policy (2000) Volume 11, Issues 1–2, included a series of articles discussing the advantages and disadvantages of the RAR method.
Make social solidarity a core concern to ensure fairness and unity of purpose
An NESC Secretariat paper,
Ireland’s economic recovery: an analysis and exploration, published in July 2011, argued that, in order to sustain and deepen the country’s economic recovery, Ireland needs to focus on ‘working the (EU/IMF) deal’ rather than debating whether it can work. It outlined five connected elements necessary for ‘working the deal’, including making social solidarity a core concern to ensure fairness and unity of purpose, which the authors explained as follows: ‘In adjusting public expenditure it is necessary to identify innovative ways of cutting costs and maintaining standards. This requires engagement of local problem-solving to ensure that expenditure is reduced in a way that does not undermine the services provided to citizens.’ The full Secretariat paper is available at
www.nesc.ie
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